Editorial | Health care now and ahead


The Supreme Court has left it up to voters to decide on health care’s short- and long-term effects




Last week, the Supreme Court ruled on the constitutionality of the Patient Protection and Affordable Care Act, the signature piece of legislation that has come to be known as “Obamacare.”

The individual mandate, which will require nearly everyone to purchase health insurance or else pay a penalty, was the most controversial portion of the legislation. In a move that surprised many observers, the conservative Chief Justice John Roberts sided with the court’s liberal justices to uphold the individual mandate as a tax. The decision will have far-reaching consequences for the political landscape and the future of health care, as well as for students.

The ACA contains several provisions that will benefit college students and young people who have just graduated. Under the law, people can remain on their parents’ health insurance plans until they are 26. Given that the age at which people are expected to be completely independent is ever increasing, ensuring a stable source of health insurance for students and recent grads can be a crucial step in getting on one’s feet financially.

Additionally, one of the cornerstones of the law — the provision that makes it illegal to discriminate based on pre-existing conditions — will undoubtedly make financial independence a more easily achievable goal for many young people.

In the short-term, at least, the Supreme Court’s ruling will benefit students.

In the long-term, however, the stability of the healthcare system is still much more unclear. Depending on how effective the mandate ends up being as well as the number of people who become insured for the first time, healthcare costs and taxes could continue to increase. If such a scenario were to play out, the ACA would have merely kicked the can down the road for the next generation of lawmakers to sort out.

Moreover, the Supreme Court ruling took some of the teeth out of the law. The only portion the court limited was the Medicaid expansion, which would have withheld federal funding from states if they did not increase the number of people covered under the government-sponsored healthcare program for low-income people. The court ruled that while the federal government can withhold new funding, it would be an unconstitutional act of coercion to withhold funding that is already in place.

States, therefore, can choose to opt out of the Medicaid expansion, which the Congressional Budget Office estimated would cover 16 million currently uninsured people. Another major healthcare reform would be necessary to plug such a hole.

The court’s ruling might also resurrect a political battle that saw its last daylight in 1987 — the debate over the legal drinking age. A law passed in 1984 threatened to deny highway funding to states if they did not institute a minimum drinking age of 21 years old. Last week’s ruling calls into question the constitutionality of such a threat, which could potentially open the door to challenges by states in the future.

As the election season heats up, the Supreme Court has left it to the voters to decide whether the Affordable Care Act is good policy — or whether it unjustly punishes people for inactivity. While there are short-term benefits for students, the long-term consequences are yet to be seen.

Given that President Barack Obama explicitly rejected the characterization of the individual mandate as a tax, Democrats will face new challenges in convincing the American public of the wisdom of “ObamaCare.”

Whether they will be successful remains to be seen.

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